Abstract：
BACKGROUND: Handovers of care are potentially hazardous moments in the patient journey and can lead to harm if conducted poorly. Through a national survey of surgical doctors in Ireland, this paper assesses contemporary surgical handover practices and evaluates barriers and facilitators of effective handover.
METHODS: After ethical approval and pre-testing with a representative sample, a cross-sectional, online survey was distributed to non-consultant hospital doctors (NCHDs) working in the Republic of Ireland. A mixed-methods approach was used, combining data using triangulation design.
RESULTS: A total of 201 responses were received (18.5%). Most participants were senior house officers or senior registrars (49.7% and 37.3%). Most people (85.1%) reported that information received during handover was missing or incorrect at least some of the time. One-third of respondents reported that a near-miss had occurred as a result of handover within the past three months, and handover-related errors resulted in minor (16.9%), moderate (4.9%), or major (1.5%) harm. Only 11.4% had received any formal training. Reported barriers to handover included negative attitudes, a lack of institutional support, and competing clinical activities. Facilitators included process standardisation, improved access to resources, and staff engagement.
CONCLUSIONS: Surgical NCHDs working in Irish hospitals reported poor compliance with international best practice for handover and identified potential harms. Process standardisation, appropriate staff training, and the provision of necessary handover-related resources is required at a national level to address this significant patient safety concern.
METHODS: After ethical approval and pre-testing with a representative sample, a cross-sectional, online survey was distributed to non-consultant hospital doctors (NCHDs) working in the Republic of Ireland. A mixed-methods approach was used, combining data using triangulation design.
RESULTS: A total of 201 responses were received (18.5%). Most participants were senior house officers or senior registrars (49.7% and 37.3%). Most people (85.1%) reported that information received during handover was missing or incorrect at least some of the time. One-third of respondents reported that a near-miss had occurred as a result of handover within the past three months, and handover-related errors resulted in minor (16.9%), moderate (4.9%), or major (1.5%) harm. Only 11.4% had received any formal training. Reported barriers to handover included negative attitudes, a lack of institutional support, and competing clinical activities. Facilitators included process standardisation, improved access to resources, and staff engagement.
CONCLUSIONS: Surgical NCHDs working in Irish hospitals reported poor compliance with international best practice for handover and identified potential harms. Process standardisation, appropriate staff training, and the provision of necessary handover-related resources is required at a national level to address this significant patient safety concern.
摘要：
背景：移交护理是患者旅程中的潜在危险时刻，如果进行得不好，可能会导致伤害。通过对爱尔兰外科医生的全国调查，本文评估了当代外科交接实践，并评估了有效交接的障碍和促进因素。
方法：经过伦理批准和具有代表性的样本的预测试，横截面，在线调查分发给在爱尔兰共和国工作的非顾问医院医生(NCHD).采用了混合方法，使用三角测量设计组合数据。
结果：共收到201份回复（18.5%）。大多数参与者是高级内务人员或高级注册人员（49.7％和37.3％）。大多数人（85.1％）报告说，移交期间收到的信息至少在某些时候丢失或不正确。三分之一的受访者表示，在过去三个月内，由于交接而发生了未遂事件，与移交相关的错误导致轻微(16.9%)，中等(4.9%)，或重大（1.5％）伤害。只有11.4%的人接受过正规培训。报告的移交障碍包括消极态度，缺乏机构支持，和相互竞争的临床活动。促进者包括流程标准化，改善对资源的访问，和员工参与。
结论：在爱尔兰医院工作的外科NCHD报告说，与国际最佳交接实践的依从性差，并确定了潜在的危害。过程标准化,适当的员工培训，需要在国家一级提供必要的移交相关资源，以解决这一重大的患者安全问题。
方法：经过伦理批准和具有代表性的样本的预测试，横截面，在线调查分发给在爱尔兰共和国工作的非顾问医院医生(NCHD).采用了混合方法，使用三角测量设计组合数据。
结果：共收到201份回复（18.5%）。大多数参与者是高级内务人员或高级注册人员（49.7％和37.3％）。大多数人（85.1％）报告说，移交期间收到的信息至少在某些时候丢失或不正确。三分之一的受访者表示，在过去三个月内，由于交接而发生了未遂事件，与移交相关的错误导致轻微(16.9%)，中等(4.9%)，或重大（1.5％）伤害。只有11.4%的人接受过正规培训。报告的移交障碍包括消极态度，缺乏机构支持，和相互竞争的临床活动。促进者包括流程标准化，改善对资源的访问，和员工参与。
结论：在爱尔兰医院工作的外科NCHD报告说，与国际最佳交接实践的依从性差，并确定了潜在的危害。过程标准化,适当的员工培训，需要在国家一级提供必要的移交相关资源，以解决这一重大的患者安全问题。
